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The 'Ideal Wound Dressing' should:
- Maintain a moist environment at wound interface
- Remove excess exudate without allowing 'strike through’ to surface of dressing
- Provide thermal insulation and mechanical protection
- Act as a barrier to micro-organisms
- Allow gaseous exchange
- Be no adherent and easily removed without trauma
- Leave no foreign particles in wound
- Be non-toxic, non-allergenic and non-sensitising
- No single dressing is appropriate for all wound types and all stages of healing
Hydrocolloids e.g. Granuflex
- Matrix of cellulose and other gel forming agents - gelatin and pectin
- Occlusive dressing
- Should be avoided if infection particularly with anaerobic organisms
- Promotes autolysis and aids granulation
- Can remain in place for up to a week
- Over-granulation can occur
Alginates e.g. Kaltostat
- Calcium and sodium salts of alginic acid obtained from seaweed
- Highly absorbent
- Useful in medium to heavily exudating wounds
- Secondary covering is required
- Forms a gel in contact with wound exudate
Foam dressings e.g. Lyofoam
- Useful for moderately exudating wounds
- Prevents 'strike through' of exudate to wound surface
- Desloughs wounds by maintaining a moist environment
Hydrogels e.g. Intrasite Gel
- High water content creates a moist wound surface
- Debrides wounds by hydration and promotion of autolysis
- Will absorb a light exudate
- Not appropriate for heavily exudating wounds
Debriding agents
- Remove eshcar and necrotic tissue
- Do not maintain moist environment
- Need frequent changes
- Varidase = streptokinase
- Aserbine = malic, benzoic and salicylic acids in a cream base
- Damages granulation tissue and delays healing
Bibliography
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